Osteomyelitis

Question 1

What is osteomyelitis?

Answer 1

Infection of the bone and bone marrow

Question 2

What is the common causative organism for osteomyelitis?

Answer 2

Staph aureus

Question 3

What are the risk factors for osteomyelitis?

Answer 3

More common in boys and children <10
Open fracture
Orthopaedic surgery
Immunosuppression
HIV
TB
Sickle cell anaemia

Question 4

What are clinical features?

Answer 4

Present either acute as typically unwell or chronically with subtle symptoms

Refusing to use limb or weight bear
Pain
Swelling
Tenderness
Aprexic or low grade fever

Question 5

What investigations need to be done?

Answer 5

Bloods- WCC, CRP and ESR will be raised
Blood cultures
MRI-look for affected bone
XR can be used but can take 7-10 days to show any abnormal signs

Question 6

What is the management?

Answer 6

Prolonged course of antibiotics

May need surgical drainage or debridement of affected bone

Question 7

What are symptoms of subacute osteomyelitis?

Answer 7

Mild to moderate pain-exacerbated by movement
Night pain
Minimal loss of function

Question 8

What are symptoms of chronic osteomyelitis?

Answer 8

If acute is not treated then it can progress to chronic or it can develop as a complication
Leads to permanent damage

Bone pain
Persistent fatigue
Local swelling
Skin changes

If untreated can lead to amputation being required